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NPI Code Detail

MEDICARE: MS. ANN E. TANNER LCSW

MEDICARE:  MS. ANN E. TANNER  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorLCS 21585CA
2101YM0800XMental Health CounselorLCS 21585CA
31041C0700XClinical Social WorkerLCS 21585CA

General Provider Information

NPI Number : 1558458307
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANN E. TANNER LCSW
Provider Business Mailing Address
First Line : 3612 CARLSBAD BLVD
Second Line :
City : CARLSBAD
State : CA
Zip : 92008
Country : US
Telephone Number : 760-720-4649
Fax Number :
Provider Business Practice Location Address
First Line : 1902 WRIGHT PLACE
Second Line :
City : CARLSBAD
State : CA
Zip : 92008
Country : US
Telephone Number : 760-419-1770
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 09/11/2025

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Directions to “ MS. ANN E. TANNER LCSW” Practice Location

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